The overall objective of this research proposal is to construct cancer incidence maps of the United States using the inpatient files from the Health Care Financing Administration (HCFA). The National Cancer Institute has published cancer mortality atlases of the United States with data that dates back to 1950. These maps give a visual representation of areas of high and low rates of cancer by site. From these visualizations it has been possible to develop hypotheses concerned with cancer etiology. In the past the atlases have utilized mortality statistics. Ibis research proposes to develop maps of cancer incidence in the Medicare population, which essentially includes almost all persons over the age of 64 who were admitted to an acute care hospital. For the years 1986 through 1989 this study will explore the value of atlases of cancer incidence rates for all counties and Standard Statistical Metropolitan Areas (SMSA) in all 50 states. Recognizing that population based incidence statistics are available from the SEER registries, which is about a 12% of the U.S. population, this study will extend the evaluation of cancer morbidity for essentially all of the U.S. population over the age of 64, this segment of the population has about 70% of all cancers in the U.S. population. The data files to be used for these studies include more than 20 million hospitalized Medicare patients. About 14% have a diagnosis of cancer. The U.S. Bureau of Census files and the Area Resource File with county information will also be used. The atlas will consist of a total of 142 national maps of cancer incidence for selected sites. Our laboratory has the databases for this project resident on our computers. We have completed a series of different national studies dealing with hip fractures and coronary artery bypass surgery using the above mentioned databases.